According to research from the Journal for Nurses in Professional Development, nurses who demonstrated enhanced patient engagement fostered stronger relationships with patients, encouraging them to be more proactive participants in their care. Even subtle body language gestures, such as sitting alongside the patient, can bolster the nurse-patient relationship, increasing overall patient satisfaction and outcomes in the clinical setting.1 This “art of nursing” – the human connection between nurse and patient formed through compassionate concern, openness, communication and empathetic attention – has been lost over the years.
Nursing literature documents the prevalence of incivility, bullying, lateral violence, and overall toxic workplace environments in educational and practice settings. In an effort to combat this trend and enhance patient satisfaction, many healthcare agencies are seeking to change or enhance their corporate culture to achieve a values-based environment focused on care and service. For example, the Cleveland Clinic’s iHeart cultural transformation emphasizes service-oriented behaviors among colleagues and patients. I can attest to a palpable culture of service at Cleveland Clinic facilities. With reimbursement for healthcare services now tied to outcomes including patient satisfaction, healthcare agencies are increasing focus on employing nurses who exemplify the values that drive these results-service, caring, integrity and professionalism.
At Chamberlain College of Nursing, we have a vision to graduate extraordinary nurses who help transform healthcare worldwide. But what, exactly, does an extraordinary nurse look like, and how does an educational institution help foster extraordinary graduates? Extraordinary nurses go above and beyond to demonstrate care and sensitivity to a patient and family by not only listening, but anticipating what might be needed or wanted. They are creative, smart, knowledgeable, professional, ethical, responsive and competent. But it is their service orientation – going above and beyond to meet another person’s needs – that is the key ingredient to extraordinary. Extraordinary nurses exemplify the values and behaviors that employers want in the nurses they hire.
The Challenge of Higher Education
A student’s experience in nursing school can help shape the values that lead to becoming an extraordinary nurse. A recent Gallup poll revealed that a primary factor in an individual’s success in school and the workplace was having a faculty member who “cared about them as a person.” Yet only 22% of those surveyed reported receiving such support in college.2 In fact, higher education institutions of all kinds often say to students at freshman orientation: “Look to your right, look to your left in a year half of you will be gone.”
Many educational environments are punitive; faculty believe students should be independent and self-motivated, so students are left to their own devices to figure out how to survive. This might work for some students, particularly at elite institutions, but it doesn’t work for all students. Most of us do our best when we are supported and encouraged, yet many students feel lost, lonely, confused, anxious, inadequate, and stressed.
Developing a Culture of Care in Nursing Education
At Chamberlain College of Nursing, we believe that if educators take extraordinary care of students, students are more likely to be successful – motivated instead of demotivated, encouraged instead of berated. Students are more likely to develop caring, ethical, professional and service-oriented values and behaviors if their educators model them.
Of these beliefs was born our model of student success, Chamberlain Care. Chamberlain Care is defined as the extraordinary service Chamberlain colleagues provide to each other and to our students to help them achieve their goals and make a tangible difference in patient care and in the advancement of the nursing profession. By infusing care into all facets of the educational experience, we can serve students in a way that first helps them succeed in school, and then helps them exemplify care and service within the health care setting at which they become employed.
Students who are exposed to the concepts of care and service on a daily basis will internalize them, just as they internalize the knowledge and skills they need to master. By meeting the needs of students through actions, expertise, and resources, faculty and staff prepare students to become extraordinary nurses who are highly skilled in the art of nursing presence – being in the moment and in immediate proximity to care for the whole person. 3
Chamberlain colleagues demonstrate Chamberlain Care through heightened student engagement, comprehensive academic resources, experiential learning activities, and robust support services including individualized tutoring and student success seminars. For example, Chamberlain’s Center for Academic Success works individually with each student to design a path to success and to help students navigate their educational journeys. The Chamberlain Care model of early student engagement increases success rates and lowers student attrition. Our career services team offers career planning and resume tools, and assists students in exploring potential employment opportunities that align with their career objectives.
Transformation to a Culture of Care
To cultivate a generation of extraordinary nurses who will go on to transform healthcare, Chamberlain had to drive a culture of care and service throughout the college so that it would be part of our DNA and provide the foundation for all student experiences. This transformation required a broad organizational approach:
- Start at the Top. Institutional leaders set the vision, created a compelling reason why others should want to follow, and consistently modeled desired behaviors.
- Talk the Talk. Unify educational teams under a common understanding of “care” and “service excellence” by defining and describing them through internal messaging and training workshops.
- Walk the Walk. Operationalize care by developing a plan of action for quality improvement.
- Be Accountable. Set benchmarks to evaluate effectiveness, measure success and assess outcomes.
- Start with the People. Any culture change is dependent on having the right people. The people who make up the Chamberlain organization are evaluated through pre-hire assessments, performance management systems and coaching.
- Build to Last. The ability to sustain a desired culture of care depends on continued focus by all colleagues.
The Outcome of Extraordinary Care
Students have benefitted from the Chamberlain Care approach through academic and employment success, evidenced through improved student engagement, satisfaction and retention. In addition, colleague and faculty engagement and satisfaction scores have soared as a result of the college’s emphasis on creating a culture of caring, colleague-to-colleague service, and fostering colleagues’ care of themselves as a prerequisite to providing extraordinary care to students.
Stationed at the front lines of health care, nurses have a responsibility to combine both the art and science of their profession to build strong relationships and deliver quality, compassionate care to patients. A high-quality, caring and service-oriented educational experience can mold nurses who embody the values and attitudes required to delivery extraordinary patient care, help transform healthcare and improve lives.
References
1. Kostovich, Carol Toliuszis PhD, RN & Clementi, Pamela S. PhD, RN-BC. “Nursing Presence: Putting the Art of Nursing Back Into Hospital Orientation.” Journal for Nurses in Professional Development: March/April 2014 – Volume 30 – Issue 2 – p 70-75.
2. Friedman, T.L. (2014) It Takes a Mentor. The New York Times. Retrieved from http://www.nytimes.com/2014/09/10/opinion/thomas-friedman-it-takes-a-mentor.html
3. Andrus V. The Integrative healing arts program training manual: Session three. In: Artistry of Authentic Communication. Florence, Mass.: BirchTree Center Press; 2011: 18.
Susan Groenwald, PhD, RN, FAAN, ANEF is president of Chamberlain College of Nursing.
